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Defending Health Care in 2017: What Is at Stake for Kentucky

With a new president and Congress, the health care gains made throughout the last six years face their greatest threat yet. Congress has voted more than 60 times to roll back the historic progress that has been made to expand health coverage to millions of people in this country and to improve coverage for those who already had it. These proposed changes will put the health—and lives—of countless Kentuckians at risk. Here’s what Kentucky stands to lose if the new president and Congress move forward to upend our health care system:

Hundreds of thousands of Kentuckians stand to lose health coverage

Approximately 56,000 Kentuckians who currently get financial assistance to help pay for their health coverage will lose this help and will no longer have affordable coverage options. In 2016, Kentuckians receiving financial assistance saw their monthly premiums reduced on average $258 thanks to this help.3

The now-historically low rate of uninsured people will spike, with the number of uninsured in Kentucky increasing 200 percent by 2019.4 This will reverse the immense progress that has been made to expand coverage. Between 2013 and 2015:

The number of uninsured in Kentucky declined 58 percent5

Working Kentuckians: The uninsured rate among working Kentuckians saw a 55 percent decline6

Repeal will end Kentucky’s Medicaid expansion and cause ripple effects across the state economy

439,000 people stand to lose health coverage, most of whom are working.7 The Medicaid expansion has extended health coverage to lower-income Kentuckians who hold down jobs that are the backbone of the state’s economy—from fast food workers to home care attendants to construction workers to cashiers. Repeal will leave these hard working Kentuckians out in the cold.

Kentucky will lose billions in federal Medicaid funding. Over the course of a year and a half alone, Medicaid expansion brought $3.5 billion in federal dollars into the state economy8 The impact of that lost federal Medicaid funding will have a ripple effect throughout the state economy, affecting hospitals, other health care providers, and businesses.

Millions of dollars in state budget relief lost. By providing health coverage to more state residents, the Medicaid expansion has meant that the state has been able to reduce its health care spending on programs like state-funded programs for the uninsured. That’s $83 million in state budget relief in state fiscal year 2015.9 These funds can be reinvested in other state priorities like infrastructure and education. Repeal will put these costs squarely back on the state.

Kentuckians with private health insurance will be stripped of vital protections against discrimination

Approximately 1.9 million Kentuckians with pre-existing conditions like asthma, diabetes, and cancer could once again be denied affordable, comprehensive coverage that actually covers their health care needs.10

Women in Kentucky will once again be charged more for health coverage just for being a woman.

Prior to the Affordable Care Act (ACA), women in Kentucky were charged as much as 57 percent more than men for the same coverage.11

Kentuckians will once again face a world where insurance plans routinely cap the most they will pay for someone’s health care in a year and in their lifetime, effectively cutting off coverage for the sickest individuals when they most need it.

Insurance companies will no longer be required to put Kentuckians’ premiums toward care, not profits

Insurers will no longer be held accountable for using people’s premium dollars on care and quality improvement or paying back the difference.

Kentuckians have received around $33.3 million in refunds from plans that overcharged for premiums since the ACA took effect.15

Thousands of seniors and people with disabilities will lose comprehensive drug coverage

The Medicare donut hole will re-open. This will leave Kentucky’s seniors and people with disabilities with a gap in prescription drug coverage and forced to pay thousands of dollars more in drug costs.

Seniors and people with disabilities in Kentucky have saved approximately $405 million on drug costs thanks to the ACA’s closing the Medicare donut hole.16

In 2015 alone, approximately 89,000 seniors and people with disabilities in Kentucky saved on average $1,108 on drug costs.17

Endnotes

1 Loss of coverage estimates are based on insurance coverage estimates for 2019 under the Affordable Care Act (ACA) and under partial repeal of the ACA through a January 2017 reconciliation bill. Linda J. Blumberg, Matthew Buettgens, and John Holahan, Implications of Partial Repeal of the ACA through Reconciliation (Washington, DC: Urban Institute, December 2016), available online at http://www.urban.org/research/publication/implications-partial-repeal-aca-through-reconciliation (last accessed Dec. 7, 2016).

2 Estimates of lost federal assistance are based on estimates of federal spending on Medicaid/CHIP and Marketplace financial assistance from 2019 through 2028 under the Affordable Care Act (ACA) and under partial repeal of the ACA through a January 2017 reconciliation bill. Linda J. Blumberg, Matthew Buettgens, and John Holahan, Implications of Partial Repeal of the ACA through Reconciliation (Washington, DC: Urban Institute, December 2016), available online at http://www.urban.org/research/publication/implications-partial-repeal-aca-through-reconciliation (last accessed Dec. 7, 2016).

7 Robin Rudowitz, Samantha Artiga and Katherine Young, What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion (Washington DC: The Kaiser Family Foundation, December 2016) available online at http://kff.org/report-section/what-coverage-and-financing-is-at-risk-under-a-repeal-of-the-aca-medicaid-expansion-appendix/ (last accessed Dec. 7, 2016).